Evaluating Affordable Cranial Ultrasonography in East African Neonatal Intensive Care Units

Abstract

Neuroimaging is a valuable diagnostic tool for the early detection of neonatal brain injury, but equipment and radiologic staff are expensive and unavailable to most hospitals in developing countries. We evaluated an affordable, portable ultrasound machine as a quantitative and qualitative diagnostic tool and to establish whether a novice sonographer could effectively operate the equipment and obtain clinically important information. Cranial ultrasonography was performed on term healthy, pre-term and term asphyxiated neonates in Rwandan and Kenyan hospitals. To evaluate the detection of ventriculomegaly and compression injuries, we measured the size of the lateral ventricles and corpus callosum. The images were also assessed for the presence of other cerebral abnormalities. Measurements were reliable across images, and cases of clinically relevant ventriculomegaly were detected. A novice sonographer had good-to-excellent agreement with an expert. This study demonstrates that affordable equipment and cranial ultrasound protocols can be used in low-resource settings to assess the newborn brain.

Surgical applications of ultrasound use in low‐ and middle‐income countries: A systematic review

“…Ultrasound provided the ability to detect ventriculomegaly, enema, cysts, intraventricular haemorrhage (IVH), abscesses, neural tube defects and paediatric brain tumours 18–21 . Early diagnosis has been shown to be of the utmost importance for the prognosis and outcome of patients with pathology potentially requiring surgery 22 . Through early detection and neurosurgical management, the morbidity and mortality related to neural tube defects have been significantly reduced 21 .…”

Moving Beyond the Stethoscope: Diagnostic Point-of-Care Ultrasound in Pediatric Practice

“…remarkably useful even in the hands of novice leaners in low-resource settings. 95 Alterations in cerebral arterial flow allow inferences to be made regarding brain pathology, although the current literature is insufficient to support its use in POCUS applications because of difficulty distinguishing changes in blood flow velocity from compression versus those due to intrinsic stenosis or changes in relative perfusion.…”

The Diagnostic Value of Cystatin C and Mild Hypothermia Therapy Based on Immunoturbidimetry Enhanced by Nanospheres in Asphyxia Neonate

“…It cannot be measured directly, but it can be measured by measuring the filter rate of a specific marker. For example, inulin removal and isotope labeling are external labels and the gold standard for evaluating glomerular filtration rate [8,9]. However, this kind of special operation is complex, expensive, and invasive, which is difficult to promote in newborns.…”